Background We randomly sampled a healthy community to evaluate the prevalence and associated risk factors of urinary incontinence. Methods The survey was performed in Fuzhou, China. Of women over twenty years of age i...Background We randomly sampled a healthy community to evaluate the prevalence and associated risk factors of urinary incontinence. Methods The survey was performed in Fuzhou, China. Of women over twenty years of age in the city, 3.0% were randomly selected and 4684 evaluated by Bristol Female Urinary Tract Symptoms Questionnaire. Results Of the women in Fuzhou, 19.0% had urinary incontinence. The prevalence of stress incontinence, urge incontinence and mixed incontinence was 16.6% (n=777), 10.0% (n=468), 7.7% (n=360) respectively. The prevalence of the three types of urinary incontinence increased significantly with age (P<0.01). In multiple logistic models, age (OR, 1.3, 95%CI, 1.1-1.4), vaginal delivery (3.0, 1.9-4.7), parity >2 (2.1, 1.5-2.9), hypertension (2.7, 1.4-5.6), constipation (2.6, 1.8-3.8), alcohol consumption (4.7, 1.1-20.2), episiotomy (1.7, 1.4-2.0), higher body mass index (BMI, 1.8, 1.5-2.2) and unskilled worker (0.7, 0.5-0.8) were potential risk factors for stress incontinence. Urge incontinence was associated with age (OR, 1.3, 95%CI, 0.9-1.3), menopause (1.6, 1.1-2.4), Caesarean delivery (0.2, 0.1-0.5), parity >2 (2.6, 1.8-3.8), constipation (2.3, 1.4-3.7), foetal birthweight (1.7, 1.1-2.4), episiotomy (1.4, 1.1-1.8), higher BMI (1.5, 1.2-2.0) and unskilled worker (0.7, 0.5-0.9). Conclusions The prevalence of urinary incontinence and its subtypes in Chinese women is lower than that of occidental women. In China, age, vaginal delivery, parity, hypertension, constipation, alcohol consumption, episiotomy, higher BMI are potential risk factors for stress incontinence. Urge incontinence is associated with age, menopause, Caesarean delivery, parity, constipation, foetal birthweight, episiotomy, higher body mass index.展开更多
Small vessel disease （SVD） is responsible for brain chronic circular disorder,and accounts for 20%–30%cases of ischemic stroke as well as cerebral hemorrhage,and to a great extent,encephalopathy.Binswanger’s disea...Small vessel disease （SVD） is responsible for brain chronic circular disorder,and accounts for 20%–30%cases of ischemic stroke as well as cerebral hemorrhage,and to a great extent,encephalopathy.Binswanger’s disease and multiple small strokes,which are common in older people,are also closely associated with SVD.These disorders often cause decline in cognition,vascular dementia,impairment in gait and balance,mood depression,and urinary incontinence,and often brings great social and economic burdens.SVD-related encephalopathy increases the incidences of fall,disability and death in elderly people.With the aging of the society,more attention should be paid to the importance of early diagnosis and prophylactic treatment of SVD.Here the clinical manifestations and pathophysiology of SVD are reviewed.展开更多
Background Traumatic damage to fascial and muscular support structures during childbirth may be a major factor of the development of stress urinary incontinence （SUI） and pelvic organ prolapse （POP）. The aim of th...Background Traumatic damage to fascial and muscular support structures during childbirth may be a major factor of the development of stress urinary incontinence （SUI） and pelvic organ prolapse （POP）. The aim of this study was to prospectively investigate the role of different childbirth strategies on POP and SUI. Methods A total of 120 selected pregnant women were recruited and divided into two groups： vaginal delivery group （n=72） and selective cesarean delivery group （n=48）. The women were questioned with SUI sheet and estimated with POP quantification （POP-Q） within 6-8 weeks after delivery. The correlations of SUI and results of POP-Q with the strategies of delivery were analyzed, ttest, X2 test, and the Mann-Witney test were used for statistical analysis. Results Among the 120 women, SUI was developed during 29-30 gestational weeks in 20 patients （16.6%）, of whom 14 （70%） had symptoms of SUI till 6 weeks postpartum. Totally 20 （16.6%） women had SUI symptoms after delivery. The prevalence of postpartum SUI was positively correlated with the occurrence of SUI during 29-30 gestational weeks （P〈0.001）. In the vaginal delivery group, 100% of the women suffered form urinary prolapse 6 weeks postpartum, while 87.5% of those in the selective cesarean delivery group developed POP （P〈0.01）. The percentages of the first- and second-degree urinary prolapse in the vaginal delivery group were 20.8% and 79.2% respectively, which were significantly different from those in the selective cesarean delivery group （64.6% and 22.9%; both P=0.000）. Conclusions Pregnancy and delivery play an etiologic role in the development of SUI and POP. The onset of SUI during late pregnancy implies a significant risk of postpartum SUI symptoms. The prevalence of POP is significantly higher after vaginal delivery than after cesarean delivery.展开更多
External and internal rectal prolapse with their affiliated rectocele and enterocele, are associated with debilitating symptoms such as obstructed defecation, pelvic pain and faecal incontinence. Since perineal proced...External and internal rectal prolapse with their affiliated rectocele and enterocele, are associated with debilitating symptoms such as obstructed defecation, pelvic pain and faecal incontinence. Since perineal procedures are associated with a higher recurrence rate, an abdominal approach is commonly preferred. Despite the description of greater than three hundred different procedures, thus far no clear superiority of one surgical technique has been demonstrated. Ventral mesh rectopexy(VMR) is a relatively new and promising technique to correct rectal prolapse. In contrast to the abdominal procedures of past decades, VMR avoids posterolateral rectal mobilisation and thereby minimizes the risk of postoperative constipation. Because of a perceived acceptable recurrence rate, good functional results and low mesh-related morbidity in the short to medium term, VMR has been popularized in the past decade. Laparoscopic or robotic-assisted VMR is now being progressively performed internationally and several articles and guidelines propose the procedure as the treatment of choice for rectal prolapse. In this article, an outline of the current status of laparoscopic and robotic ventral mesh rectopexy for the treatment of internal and external rectal prolapse is presented.展开更多
文摘Background We randomly sampled a healthy community to evaluate the prevalence and associated risk factors of urinary incontinence. Methods The survey was performed in Fuzhou, China. Of women over twenty years of age in the city, 3.0% were randomly selected and 4684 evaluated by Bristol Female Urinary Tract Symptoms Questionnaire. Results Of the women in Fuzhou, 19.0% had urinary incontinence. The prevalence of stress incontinence, urge incontinence and mixed incontinence was 16.6% (n=777), 10.0% (n=468), 7.7% (n=360) respectively. The prevalence of the three types of urinary incontinence increased significantly with age (P<0.01). In multiple logistic models, age (OR, 1.3, 95%CI, 1.1-1.4), vaginal delivery (3.0, 1.9-4.7), parity >2 (2.1, 1.5-2.9), hypertension (2.7, 1.4-5.6), constipation (2.6, 1.8-3.8), alcohol consumption (4.7, 1.1-20.2), episiotomy (1.7, 1.4-2.0), higher body mass index (BMI, 1.8, 1.5-2.2) and unskilled worker (0.7, 0.5-0.8) were potential risk factors for stress incontinence. Urge incontinence was associated with age (OR, 1.3, 95%CI, 0.9-1.3), menopause (1.6, 1.1-2.4), Caesarean delivery (0.2, 0.1-0.5), parity >2 (2.6, 1.8-3.8), constipation (2.3, 1.4-3.7), foetal birthweight (1.7, 1.1-2.4), episiotomy (1.4, 1.1-1.8), higher BMI (1.5, 1.2-2.0) and unskilled worker (0.7, 0.5-0.9). Conclusions The prevalence of urinary incontinence and its subtypes in Chinese women is lower than that of occidental women. In China, age, vaginal delivery, parity, hypertension, constipation, alcohol consumption, episiotomy, higher BMI are potential risk factors for stress incontinence. Urge incontinence is associated with age, menopause, Caesarean delivery, parity, constipation, foetal birthweight, episiotomy, higher body mass index.
文摘Small vessel disease （SVD） is responsible for brain chronic circular disorder,and accounts for 20%–30%cases of ischemic stroke as well as cerebral hemorrhage,and to a great extent,encephalopathy.Binswanger’s disease and multiple small strokes,which are common in older people,are also closely associated with SVD.These disorders often cause decline in cognition,vascular dementia,impairment in gait and balance,mood depression,and urinary incontinence,and often brings great social and economic burdens.SVD-related encephalopathy increases the incidences of fall,disability and death in elderly people.With the aging of the society,more attention should be paid to the importance of early diagnosis and prophylactic treatment of SVD.Here the clinical manifestations and pathophysiology of SVD are reviewed.
文摘Background Traumatic damage to fascial and muscular support structures during childbirth may be a major factor of the development of stress urinary incontinence （SUI） and pelvic organ prolapse （POP）. The aim of this study was to prospectively investigate the role of different childbirth strategies on POP and SUI. Methods A total of 120 selected pregnant women were recruited and divided into two groups： vaginal delivery group （n=72） and selective cesarean delivery group （n=48）. The women were questioned with SUI sheet and estimated with POP quantification （POP-Q） within 6-8 weeks after delivery. The correlations of SUI and results of POP-Q with the strategies of delivery were analyzed, ttest, X2 test, and the Mann-Witney test were used for statistical analysis. Results Among the 120 women, SUI was developed during 29-30 gestational weeks in 20 patients （16.6%）, of whom 14 （70%） had symptoms of SUI till 6 weeks postpartum. Totally 20 （16.6%） women had SUI symptoms after delivery. The prevalence of postpartum SUI was positively correlated with the occurrence of SUI during 29-30 gestational weeks （P〈0.001）. In the vaginal delivery group, 100% of the women suffered form urinary prolapse 6 weeks postpartum, while 87.5% of those in the selective cesarean delivery group developed POP （P〈0.01）. The percentages of the first- and second-degree urinary prolapse in the vaginal delivery group were 20.8% and 79.2% respectively, which were significantly different from those in the selective cesarean delivery group （64.6% and 22.9%; both P=0.000）. Conclusions Pregnancy and delivery play an etiologic role in the development of SUI and POP. The onset of SUI during late pregnancy implies a significant risk of postpartum SUI symptoms. The prevalence of POP is significantly higher after vaginal delivery than after cesarean delivery.
文摘External and internal rectal prolapse with their affiliated rectocele and enterocele, are associated with debilitating symptoms such as obstructed defecation, pelvic pain and faecal incontinence. Since perineal procedures are associated with a higher recurrence rate, an abdominal approach is commonly preferred. Despite the description of greater than three hundred different procedures, thus far no clear superiority of one surgical technique has been demonstrated. Ventral mesh rectopexy(VMR) is a relatively new and promising technique to correct rectal prolapse. In contrast to the abdominal procedures of past decades, VMR avoids posterolateral rectal mobilisation and thereby minimizes the risk of postoperative constipation. Because of a perceived acceptable recurrence rate, good functional results and low mesh-related morbidity in the short to medium term, VMR has been popularized in the past decade. Laparoscopic or robotic-assisted VMR is now being progressively performed internationally and several articles and guidelines propose the procedure as the treatment of choice for rectal prolapse. In this article, an outline of the current status of laparoscopic and robotic ventral mesh rectopexy for the treatment of internal and external rectal prolapse is presented.
